The document discusses mental status assessment. It defines mental status as a person's emotional and cognitive functioning, which allows them to function socially and occupationally. A traumatic life event can tip the balance of mental status and cause transient dysfunction. Assessing mental status during traumatic events can identify strengths and help individuals mobilize coping skills. Optimal functioning aims for life satisfaction in relationships, work, and within oneself. The document also discusses factors that can affect the interpretation of mental status examinations, such as medical conditions or medications. It provides details on components assessed in a mental status exam including appearance, behavior, mood, affect, orientation, and cognitive functions.

1. Mental status assessment
DR SUHA OMRAN
HEBA ALSAQER
2021

2. We believe that every human being
deserves to live a meaningful life. What we
consider meaningful depends on our
personal values and gives us the strength
to cope with adversities, including
traumatic experiences and difficult life-
transitions.

4. Mental status is a
persons emotional (
feeling ) and
cognitive function
Mental status strikes a
balance , allowing the
person to function
socially and
occupationally.
The stress surrounding
a traumatic life event
tips the balance ,
causing transient
dysfunction
Mental status assessment
during a traumatic life
event can identify
remaining strength and
help individual mobilize
resources and use coping
skills
Optimal functioning aims
toward life satisfaction in
work , in caring relationship
and within the self

5. Mental disorder
is defined as a significant
behavioral or
psychological pattern that
is associated with distress (
a painful symptom) or
disability ( impaired
functioning ) and has a
significant risk of pain,
disability , death or loss of
freedom. Type of MD:
1- organic disorders due to
brain disease of known specific
organic cause e.g.Dementia
2- psychiatric mental illness in
which an organic etiology
hasn’t yet been established e.g.
schizophrenia.

6. Question?
Can you scrutinized
Mental status directly
like heart sound ?

7. “
”
Assessment of individual
behaviors

8. consciousness
languages
Mood and affect
orientation
perception
Consciousness: Being aware of one's own existence,
feelings, and thoughts and of the environment
Using the voice to communicate one's thoughts and
feelings.
Affect is temporary expression of feelings or state of mind, and
mood is more durable, a prolonged display of feelings that
color the whole emotional life.
awareness of the objective world in relation to the self,
including person, place, and time.
An awareness of objects through the five senses.( hallucination
and illusion )

9. attention
memory
Abstract reasoning
Thought process
THOUGHT CONTENT
The power of concentration, the ability to focus on
one specific thing without being distracted by many
environmental stimuli
The ability to lay down and store experiences and perceptions
for later recall. Recent memory evokes day-to-day events;
remote memory brings up years' worth of experiences.
Pondering a deeper meaning beyond the concrete and literal
The way a person thinks; the logical train of thought
(LIKE Neologism BLOCKING flight ideas ).
What the person thinks—specific ideas, beliefs, the use of
words. (PHOBIA compulsion obsession)

10. “
”
Developmental Competence

11. Emotional and cognitive functioning mature progressively from
simple reflex behavior into complex logical and abstract thought
Example :-
 Consciousness : develops along with language so that, by(
18 to 24) months, the child learns that he or she is separate
from objects in the environment and has words to express
this.
 Attention gradually increases( preschool years )
 thinking At( 7 years) becomes more logical and systematic,
and the child is able to reason
 Abstract thinking , the ability to consider a hypothetical
situation, usually develops between ( 12 and 15 years).

12. . Adolescents ages childhood
mental disorder is one that is
diagnosed and begins in
childhood (e.g., attention
deficit/hyperactivity disorder
[ADHD], behavioral or conduct
problems, anxiety, depression,
autism spectrum disorders)

14. Anxiety and depression among school students in Jordan: Prevalence, risk
factors, and predictors
Purpose: to assess the prevalence of anxiety and depression, examine their
relationships with sociodemographic factors and Internet addiction, and identify their
main predictors among Jordanian school students aged 12-18 years.
Design and methods: A descriptive correlational study was conducted on a random
sample of 800 students from 10 public schools in Amman 2017 . Symptom Checklist-
anxiety, Center for Epidemiological Studies Depression Scale for Children, and Young's
Internet Addiction Tool were used for the purpose.
Findings: Overall, 42.1 and 73.8% of the students were experiencing anxiety and
depression. Risk factors for both problems were school class and Internet addiction,
with the latter being the main predictor
.
Practice implications: Increasing students' and stakeholders' awareness of mental
illnesses and health programs and developing counseling centers to meet the
students' needs are necessary.
Pup med wipe site

15. The Aging Adult
* Age-related changes in sensory perception can affect mental status. For
example, vision loss ) may result in apathy, social isolation, and depression.
* chronic diseases (e.g., heart failure, cancer, diabetes, osteoporosis)
may increase the fear of loss of independence or of death.

16. Component of mental status
examination ( ABCT)
behavior
Appearance
Thought
process
cognition

17. when to perform a full mental status exam :
- initial brief screening suggests anxiety disorder or depression
family members are concerned
-brain lesions (trauma, tumor, CVA)
-aphasia ( the impairment of language ability secondary to brain
damage).
- symptoms of psychiatric mental illness.

18. factors that could affect interpretation of MSE:
1- known illness or health problems (alcoholism, renal disease)
2- current medications whose side effects may cause
depression or confusion.
3- the usual educational and behavioral level.
4- responses to personal history questions indicating current
stress, drug use, sleep habits etc.

19. Objective
data…

20. 1-POSTURE - erect and position is relaxed
abnormal : curled in bed ,restlessness with
hyperthyroidism or anxiety;
slumped in chair with depression or
organic brain disease
Appearance

21. Slumped in chair

22. Curled in bed

23. 2- BODY MOVEMENTS
-voluntary, deliberate, coordinated, smooth and
even.
- abnormal : restless ,hyperkinetic with anxiety ,
bizarre gesture with schizophrenia.

24. Bizarre posture

25. Hyperkinetic

26. 3- DRESS
appropriate for season, age, gender, setting
abnormal : inappropriate dress with organic
brain syndrome; eccentric dress with
schizophrenia or mania syndrome.

27. Eccentric dress

28. Old women dress
girl dress

29. 4- GROOMING+HYGIENE :
-clean and well groomed
abnormal : unilateral neglect
post-CVA;
lack of concern for appearance
in depression and Alzheimer.

30. Behavior
1-LEVEL OF CONSCIOUSNESS - awake alert aware
Abnormal : confused loos track of conversation
2-SPEECH – quality of speech by noting that the person makes laryngeal
sounds effortlessly and sharing conversation appropriately , the pace of
conversation moderate , articulation ( ability to form words) is clear.
Abnormal : silent un communicative
3-MOOD+AFFECT –
appropriate; ask(( how do u feel today?))
abnormal : mood swings with mania; bizarre with schizophrenia

31. 4-FACIAL EXPRESSION
appropriate , comfortable
eye contact *
abnormal : masklike
expression in
parkinsonism, depression

32. Cognitive functioning
1-ORIENTATION - knows date, place, time
abnormal : w/delirium and dementia
2-ATTENTION SPAN -
abnormal : digression from initial thought, irrelevant replies to
questions
3-RECENT MEMORY - can recall 24 hrs
abnormal : dementia, delirium, Korsakoffs syndrome

34. 4-REMOTE MEMORY - recalls events in past
abn: lost when cortical storage area for memory is damaged
(Alzheimer
, trauma to brain region)
5-NEW LEARNING - 4 unrelated words test
abn: Alzheimer's, dementia, anxiety, depression

35. additional tests for aphasia
 word comprehension - point at objects and ask person to
name them
 reading - ask to read print.
 writing - ask to write a sentence.

37. tests for higher intellectual function
 measure problem solving and reasoning abilities
ex: count back from 100 by 7s
 - must be assessed considering cultural and educational
background
 - can be used to discriminate between organic brain disease and
psychiatric disorders (errors on test = organic dysfunction)
)) little evidence that they are valid to detect brain disease((

38. tests for judgement
 a person exercises judgement when she can compare and
evaluate alternatives in a situation and reach an appropriate
course of action

ex: you walked down the street and found a stamped letter -
what would you do?
normal: decisions are realistic

abn: mental retardation, emotional dysfunction, schizophrenia,
brain disease

39. THOUGHT PROCESSES AND PERCEPTIONS
1 -THOUGHT PROCESSES – ask yourself ( can I follow what the person is
saying ? )
2-CONTENT - person says logical and consistent thin
abnormal : obsessions, compulsions
3-PERCEPTIONS –the person should be consistently aware of reality.
abn: illusions, hallucinations
SCREEN FOR ANXIETY, DEPRESSION, SUICIDE

40. screen for anxiety disorders
 GAD test for
presentation and
severity of anxiety:-
ask first 2 questions
from GAD. if first two
yield positive, ask the
other five
5 = mild
10 = moderate
15 = severe

41. screen for depression
 ask "in the past two weeks have you felt down, depressed, hopeless?"
- positive answers need further diagnostic interviews such as DSM-IV-TR

42. screen for suicidal thoughts
When person expresses feelings of sadness, hopelessness or grief.
One in 100 deaths is by suicide according to Who IN Jan 2021.
it is important to assess any possible risk of physical harm to
himself or herself by starting with general questions then get
specific if you hear affirmative answer for example :

43. .Have you ever felt so blue that you
thought of hurting yourself?
 Do you feel like hurting yourself now?
 Do you have a plan to hurt yourself?
 What would happen if you were dead?
 How would other people react if you
were dead?

46.  give you a quantifiable measure of cognitive functions of MSE
valid detector of organic disease
normal = 27
18 - 23 = mild cog dysfunction
0 - 7 = severe cog dysfunction
mini mental state examination (MMSE)

47. Aims: In this study, we aimed to estimate the prevalence of quarantine-related anxiety and its
socioeconomic correlates.
Methods: An online questionnaire was utilized to collect information about quarantine-related
anxiety and related factors from a non-representative sample of Jordanian population in March
2020.
Results: Overall, 5274 participants returned the survey.
Conclusion study showed that about 40% of the participants experienced some degree of
quarantine-related anxiety.
findings :showed that approximately 1 out of every 10 participants experienced quarantine-related
anxiety .
who
The impact of the COVID-19 pandemic on mental health: early quarantine-
related anxiety and its correlates among Jordanians

48. Spiritual Needs
Meaning and purpose in life
Faith or trust in someone or something beyond ourselves
Hope and Love
Forgiveness
 If someone is hopeless they have a spiritual need

49. Nursing Diagnosis Categories
Health Promotion
Nutrition
Activity/Rest
Coping/Stress Tolerance
Safety/Protection

50. Depression in epilepsy •
One of most common psychiatric disorders among people with epilepsy. •
Having epilepsy increases the risk of depression

52. any question‫؟‬

53. THANKS……